Peterzan Mark A, Lewis Andrew J M, Neubauer Stefan, Rider Oliver J
University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Cardiovasc Diagn Ther. 2020 Jun;10(3):625-635. doi: 10.21037/cdt-20-275.
Cardiac metabolism and function are intrinsically linked. High-energy phosphates occupy a central and obligate position in cardiac metabolism, coupling oxygen and substrate fuel delivery to the myocardium with external work. This insight underlies the widespread clinical use of ischaemia testing. However, other deficits in high-energy phosphate metabolism (not secondary to supply-demand mismatch of oxygen and substrate fuels) may also be documented, and are of particular interest when found in the context of structural heart disease. This review introduces the scope of deficits in high-energy phosphate metabolism that may be observed in the myocardium, how to assess for them, and how they might be interpreted.
心脏代谢与功能存在内在联系。高能磷酸化合物在心脏代谢中占据核心且不可或缺的地位，将氧气和底物燃料输送至心肌与外部做功相耦合。这一认识是缺血检测在临床广泛应用的基础。然而，也可能记录到高能磷酸代谢的其他缺陷（并非继发于氧气和底物燃料的供需不匹配），当在结构性心脏病背景下发现这些缺陷时，尤其值得关注。本综述介绍了心肌中可能观察到的高能磷酸代谢缺陷的范围、如何评估这些缺陷以及如何解读它们。
